Freight Management Team Inc. PO BOX 460, Avon OH 44011 P 216 862 0187 F: 216 862 0368 Fax Cover Sheet To: Fax Number: Phone Number: RE: Freight Management Team Inc Carrier Information From: Pages: Date: CC: Urgent X For Review Please Comment X Please Reply Please Recycle *Comments Please review and complete the attached packet. Feel free to let us know if you have any questions, comments, or concerns. Page 1 of 8 Freight Management Team Inc. PO BOX 460, Avon OH 44011 P 216 862 0187 F: 216 862 0368 Thanks for choosing Freight Management Team, Inc. Please take the time to: 1. Please complete all of the attached forms. We will not accept any edits or changes to our contract. 2. Along with the completed forms, please attach a copy of your contract authority, a copy of your DOT carrier safety rating, and a current W-9. 3. Have your insurance company fax or make arrangements to send us a copy of your cargo insurance certificate. 4. We will NOT dispatch your truck until we have all of the above paperwork, or unless other arrangements have been made with our operations team. PLEASE FAX ALL INFORMATION TO 216 862 0368 ATTENTION: CARRIER RELATIONS Freight Management Team, Inc. – Company Information Credit Information Federal ID # 46-0576921 BROKER MC 793115 SUB O B Bank Information JPMorgan Chase Bank, N.A. 29656 Detroit Rd Westlake, OH 44145 Contact: Michele Garcia Phone: 440 892 1500 Bond Holder 1st Security Financial Corporation Contact: Nora Ashcraft Phone: 614 834 8141 Credit References Global Freight Management Contact: Ramona Phone: 440.748.0625 Fax: 440.748.0628 DS Express Contact: Igor Phone: 419.433.6200 Fax: 419.433.6029 Cleveland Express Trucking Contact: Rita Phone: 216.348.1007 Fax: 216.348.0999 Page 2 of 8 Freight Management Team Inc. PO BOX 460, Avon OH 44011 P 216 862 0187 F: 216 862 0368 Carrier Profile Sheet General Carrier Information Carrier Name: _____________________________________________________________________________ Physical Address: __________________________________________________________________________ City: _______________________________________ State: _______________ Zip Code: _____________ Billing Address (if different from above): _________________________________________________________ City: _______________________________________ State: _______________ Zip Code: _____________ 800 Phone Number: ____________________________ Local Phone Number: __________________________ Fax Number: __________________________________ Contact Information Owner / President:__________________________________________________________________________ Dispatch/Operations Supervisor: ___________________________________ Title: _______________________ Extension: _______________ Cell Phone Number (Optional): ______________________________________ Email: _______________________________ Dispatch Contacts Name: ____________________________ Phone Number: _____________________ Extension: _________ Name: ____________________________ Phone Number: _____________________ Extension: _________ Name: ____________________________ Phone Number: _____________________ Extension: _________ Available Equipment Equipment Type: ____________________ Available Sizes: _____________ # of Units Available: ________ Number of Drivers Licensed for Hazmat: _________ Federal ID Number: ______________________________ MC Number: _______________________________ DOT Number: ___________________________________ Page 3 of 8 Freight Management Team, Inc. PO BOX 460, Avon OH 44011 P 216 862 0187 F: 216 862 0368 INFORMATION REQUIRED FOR TAX PURPOSES Name: ____________________________________ Address: ____________________________________ ____________________________________ Employee Identification Number/ Social Security Number: ____________________________________ PLEASE CHECK APPROPRIATE BOX [ ] Individual/Sole Proprietor [ ] Corporation [ ] Partnership [ ] Other ______________________________ I certify the above information to be correct and am not subject to backup withholding. Signature: _______________________________ Date: ____________________________ * Please complete this form and send with W-9 Page 4 of 8 Freight Management Team, Inc. PO BOX 460, Avon OH 44011 P 216 862 0187 F: 216 862 0368 Reducing Exposure to Claims Your company has accepted a load tender from Freight Management Team, Inc. Please help us in minimizing unnecessary freight claims. Please read and acknowledge this agreement. By accepting and picking up a load for us, you hereby agree to the following: 1. Your driver is responsible for the count and condition of the load for which he/she signs. If for any reason there is a question regarding count or condition at the time of loading,Freight Management Team, Inc must be notified immediately. It is beneficial and advisable to sign for both the number of skids and piece count. 2. If the driver is not allowed access to observe loading, the boll of lading must be signed: “Shipper load and count.” The trailer must be sealed and the seal number recorded on the original bill of lading. It is a good idea to seal every trailer and record the number on the bill of lading. 3. When a sealed trailer arrives at the consignee, the seal must be observed and broken by the consignee. Please make sure the receiving agent notes on every signed bill of lading: ”Seal intact.” 4. In the event of a discrepancy at the time of delivery, Freight Management Team,. must be notified immediately. We will give your driver further instructions as to what action to take, what we want signed on the bill of lading, etc. Again, if the trailer is sealed, the seal must be broken by the consignee and “Seal intact,” should be noted on the bill. Shortages and damages do occur. Unfortunately, the communication at the time of delivery is seldom what it needs to be. By following these simple guidelines, you can help minimize and/or eliminate your exposure to a claim. The drivers’ failure to follow these instructions will almost always lead to a claim against your company. Many claims can be eliminated by using proactive communication. When we can involve our customers in sorting out discrepancies at the time of delivery, we will do so. While adhering to the above procedures is no guarantee against a claim, it will greatly reduce the chance of any claims being filed. I acknowledge the above agreement and agree to its terms. Carrier: _________________________________ Date: _________________________________ Page 5 of 8 Freight Management Team, Inc. PO BOX 460, Avon OH 44011 P 216 862 0187 F: 216 862 0368 SERVICE DATE July 16, 2012 FEDERAL HIGHWAY ADMINISTRATION LICENSE MC 793115 Freight Management Team INC. Avon, OH, US This License is evidence of the applicant’s authority to engage in operations, in interstate or foreign commerce, as a broker, arranging for transportation of freight (except household goods) by motor vehicle. This authority will be effective as long as the broker maintains insurance coverage for the protection of the public (49 CFR 387) and the designation of agents upon whom process may be served (49 CFR 366). Applicant shall also render reasonably continuous and adequate service under this authority. Failure to maintain compliance will constitute sufficient grounds for revocation of this authority. Jeffrey L Secrist Chief, Information Technology Operations Division Page 6 of 8 Freight Management Team, Inc. PO BOX 460, Avon OH 44011 P 216 862 0187 F: 216 862 0368 MOTOR CONTRACT CARRIER AND BROKER AGREEMENT This AGREEMENT made the _____ day of __________ 20___, by and between __________________________, an Interstate Commerce Commission (ICC) authorized MOTOR CONTRACT CARRIER licensed under permit No. MC _____________ SUB ___, herinafter referred to as “CARRIER,” AND Freight Management Team INC., a Federal Highway Administration authorized property broker under license number MC793115, hereinafter referred to as “BROKER.” 1. BROKER agrees to offer for shipment and CARRIER agrees to transport in its own equipment, quantities of freight agreed to by both CARRIER and BROKER. 2. CARRIER shall comply with the financial responsibility, and legal requirements of the appropriate federal and state laws and regulatory agencies through which it is authorized to operate. CARRIER shall maintain primary cargo insurance in an amount equal of the full value of the maximum value of goods to be transported at any one time under this agreement, with a minimum insurance of $100,000.00 required. CARRIER shall also maintain primary liability insurance in an amount sufficient to cover all liability risks associated related to this agreement, not to be less than $1,000,000.00. CARRIER shall maintain worker’s compensation coverage for all personnel employed by CARRIER in connection with this agreement. CARRIER agrees to give 30 days notice prior to cancellation of insurance policies. 3. BROKER agrees to pay CARRIER agreed amount within 30 days of receipt of an original, cleanly signed bill of lading. CARRIER shall be liable to BROKER and/or Shipper for any loss or damage noted on bill of lading. Any additional charges to BROKER must be approved in writing by BROKER. 4. CARRIER shall be responsible to comply with all applicable ICC and DOT regulations as well as all other federal and state regulations pertaining to the operations of a motor carrier. 5. CARRIER agrees to hold BROKER harmless from and indemnify BROKER for any liability resulting from loss or damage to any freight transported by CARRIER pursuant to this agreement, including all costs to defend claims. CARRIER agrees to hold BROKER harmless from and indemnify BROKER for any liability resulting from personal injury or property damage which may occur during the operations of CARRIER pursuant to this agreement, including all costs to defend claims. 6. CARRIER, without the prior written consent of BROKER, shall not cause or permit any shipment tendered hereunder to be brokered to or transported by any other motor carrier. 7. The relationship of CARRIER and BROKER shall, at all times, be that of an independent contractor except that BROKER shall be the agent for the CARRIER for the collection and payment of charges to CARRIER. CARRIER agrees to bill the BROKER and no one else for payment of services rendered under this agreement. Page 7 of 8 8. This contract is made pursuant to 49 U.S.C. 10923, which authorizes CARRIER to enter into contracts with purchasers of motor carrier services set forth in this Contract. The Contract is drawn up pursuant to 49 CFR 1053 inclusive. This Contract does not alter the rights and obligations of the parties regarding the transportation subject to this Contract under Title 49 U.S.C., the Bill of Lading Act and common law, except as provided herein. 9. CARRIER agrees that neither it, nor any of its employees or agents, will back solicit the business of any shipper with whom it or they come into contact with or become aware of as a result of any shipments tendered to CARRIER by BROKER pursuant to this Agreement. If CARRIER breaches the terms of this paragraph, BROKER will then be entitled to as a commission from the CARRIER of fifteen percent (15%) of the revenue received for a period of twelve (12) months after the traffic first began to move. CARRIER understands and agrees that the provisions of the aforementioned covenant not to compete and reasonable as to scope, duration, and geographic area. 10. In the event that there is dispute between CARRIER and BROKER, both parties agree that all suits must be filed in the State or Federal Court in Cuyahoga County, in the State of Ohio. 11. Reefer. Carrier warrants that the carrier will inspect or hire a service representative to inspect a vehicle’s refrigeration or heating unit at least once each month. Carrier warrants that they shall maintain a record of each inspection of refrigeration or heating unit and retain the records of the inspection for a least one year. Copies of these records must be provided upon request to the carrier’s insurance company and Broker. Carrier warrants that they will maintain adequate fuel levels for the refrigeration or heating unit and assume full liability for claims and expenses incurred by the Broker or the shipper for failure to do so. The carrier must provide their cargo insurance with all records that relate to a loss and permit copies and abstracts to be made from them upon request. Carrier shall endeavor to maintain a satisfactory U.S. DOT safety rating The following rules shall apply: (a) Destination market value for lost or damaged cargo, no special or consequential damages unless by special agreement; (b) Claims will be filed with Carrier by Shipper; (c) claims notification procedures will be followed in accordance with procedure described in 49 C.F.R. 370.1-11. 12. Additional Insured. Broker must become an additional insured and certificate holder of Carrier. IN WITNESS WHEREOF, the parties have executed this Contract at the date and place first set forth above. CARRIER:__________________________________ BY:__________________________________ (Authorized Signature) __________________________________ (Please Print Name) TITLE:___________________________________ BROKER: Freight Management Team INC. PO BOX 460, Avon OH 44011 Page 8 of 8
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